Rupture Read online

  Basetti removed a plastic bag and held it in front of Eli’s face. “Do you know what this is?”

  Within the bag was a 60-mm culture dish, standard supply in all molecular-based laboratories. The liquid media had leaked out and looked like pink lemonade poured in a baggie. Eli could see a thin, opaque layer on the bottom of the dish. He knew exactly where the dish had come from and reached out to grab it.

  Basetti pulled it back quickly.

  “Finders keepers.”

  “That’s very important to my lab,” Eli said, pointing to the cells floating in a nonsterile baggie. “Why did you take them out of the incubator?”

  “Hold on there, Jekyll,” Lipsky said. “Go ahead, tell him, Basetti.”

  Basetti motioned to the culture hood. He tugged on Vera’s elbow until her hand flopped into view, a balled, white-knuckled fist, even in death.

  “See this hand?” he asked Eli. “Had to pry that little dish from it. She was holding it so tight that she cracked the top of the glass.” Basetti turned the bag so that Eli could see the star-shaped crack.

  Immediately, Eli took two steps toward the incubator and opened it before Basetti could stop him. All the other plates of cells were gone.

  “I need those cells,” Eli said as he pointed at what was now evidence in a murder investigation.

  “Yeah,” Lipsky sneered. “I bet you do.”

  The week before he finished his surgical residency at Vanderbilt, Eli met with his mentor, Dr. Dezillion, to outline his plans to become a principal investigator of his own laboratory. His only hope for success was to take the MMP cells with him and continue the line of cancer research.

  Even though Eli had performed all the work in establishing the cell line, the cells remained the intellectual and physical property of the Dezillion lab. Eli asked for permission to study the cells and promised to keep her involved in his findings, a scientific collaboration that could be beneficial to them both. Dr. Dezillion agreed and even gave Eli a going away party in her Belle Meade home.

  Rather than carry the cells to Memphis in his car and risk damage or infection, Eli had them transported in a special biohazard package by express courier to the laboratory of Dr. Benjamin Plank. Ben was a classmate from medical school who had stayed on as faculty at the University of the Mid-South to start his own laboratory.

  Ben had kept the cells in his lab and followed the culture protocols that Eli had sent him. The day Eli received the key to his lab, they transferred ten plates of cells into Eli’s incubator. The incubator in which only one of the ten plates now remained. And that plate was upside down in a Baggie held by a college kid in shorts and sneakers.

  “You’ve got to put them back in the incubator,” Eli told them. “The cells will die.”

  “What are you talking about, cells?”

  “You know, cells. That make up the human body.”

  Lipsky pointed at Vera’s corpse. “Her body?”

  Eli rolled his eyes. A discussion with Lipsky on cellular biology would go nowhere, fast.

  “No, not her body. Anybody’s body.”

  “Anybody’s body?”

  Eli was certain this was the most absurd conversation he had ever been a part of. During his senior year at Ole Miss, after he had been accepted to medical school and was just riding out the year, Eli visited public elementary schools in Oxford. He talked to the kids about science and biology, stimulating their interest in the health-related professions. Eli looked at Lipsky, trying to write on his notepad. The third graders had caught on faster.

  “Now, about those body cells —”

  Eli stopped him in mid-sentence. “I told you, damn it. Someone has stolen the cells.”

  Lipsky glanced at Basetti. “Dr. Hyde seems to be more upset about his precious cells than the sardine-stuffed dead woman that just happens to be ten feet from his office!” As Lipsky finished the sentence, he was all but shouting. But both of them were distracted by a thick hand that reached past Lipsky and came to rest on Eli’s shoulder.

  “Dr. Branch.”

  Fisher.

  Perfect timing.

  “I need to talk with my colleague, gentleman,” Fisher said, addressing Lipsky and Basetti. “If you’ll excuse us.”

  Fisher’s presence was dominating. Bull shoulders rolled forward, ready to charge. Lipsky had probably had enough anyway.

  “Okay, Doc, we’ll be back in touch.” He flipped his right hand forward in some made-up high-society gesture. “You fine sirs have a nice day.”

  Awkwardly, Eli tried to follow Fisher, but he had to squeeze by the detective in the doorway. Lipsky leaned forward to Eli’s ear. “Don’t leave town for a few days. Hear me, doc?”

  As if finding his only employee murdered in his lab were not enough, with the Memphis police force and media now on his trail, the thought of Karl Fisher on the attack was unbearable.

  Of all the mornings to sneak across town for a job interview, I had to choose this one.

  He followed Fisher through the crowded laboratory into the hallway. Most of the employees had returned to their respective labs. Fisher turned to face Eli, a bull ready to charge.

  “Where the hell were you?”

  Fisher would have checked the OR schedule to see if Eli had an operation scheduled. His clinic patients had been canceled. There was only one other place he should have been.

  In his lab.

  Eli could not think of an adequate excuse, and Fisher did not give him a chance to come up with one.

  “A little heads up for you, Branch.” His face was bright red and swollen, saliva pooled in the corner of his mouth. He thrust a fat finger in Eli’s face and it popped him on the end of the nose. “I don’t like it when the police interrupt my morning coffee!”

  He was shaking mad, a pent-up cauldron that had boiled over while he waited for Eli to be questioned.

  “Do you understand?”

  Through the doorway, he waved his finger at the crime-scene investigation, as though giving a decree. “Now, clear this shit out. Hear me?”

  Eli looked back at the lab with the police procedures still in full swing.I’ll just say shoo and maybe they’ll all run away.

  Fisher was already walking toward the elevator. Without looking back, he said, “I expect you in my office before the end of the day.”

  CHAPTER TWENTY-FOUR

  AUTOPSY SUITE

  2:30 P.M.

  When Eli arrived, the body had been left waiting almost twenty-four hours. After Meg’s description on the phone, he was unsure if “a pattern in the deaths” was what he wanted to find. He entered the autopsy suite and was relieved when the doors closed behind him. Over the course of the morning, he had been offered a lucrative position in a leading biotech firm, then questioned as a murder suspect. Eli was glad to see Ms. Conch sitting behind her desk, a wide grin beneath horn-rimmed glasses.

  “Look what the cat dragged in.”

  “Nice to see you too, Ms. Conch.”

  “What’s going on over there in your lab?” She tilted her head and looked at him sideways, completely entertained. “They say it’s some kind of sex ring-murder tryst.”

  The comment caught Eli off guard and he let out a much needed laugh. If there was one thing he could deny, unequivocally, it was proximity to sexual relations of any kind.

  “I hate to disappoint you, but it’s not quite that interesting.”

  “Don’t hold out on me now,” she said. “Gets sort of dead down here, you know?” She started to laugh at her pun, but it came out in a jiggle-bounced burp. “Excuse me,” she said, the back of her hand placed against her lips like a debutante.

  “Dr. Daily called me,” Eli said and pointed his way out of the conversation.

  “I know. Go on back.”

  Eli walked past an empty body cart and Ms. Conch’s desk at a more cautious distance than usual.I’ve got to find another way into this place.

  “Call me if anything juicy happens.”

  Eli gave her an o
dd look.

  “You know,” she said with a wink, “over in your lab.”

  Meg was deep into the procedure, both hands beneath the lungs as she made the final cut of her thoracic evisceration.

  “Sorry I’m late,” Eli said. “Got held up in my lab.”

  Either Meg was unaware of what had happened, or she chose not to bring it up. Eli was glad not to talk about it.

  “What did you find?” he asked.

  Meg continued the dissection. “This poor fellow was found under an overpass. Probably heat exhaustion.” She pointed with a pair of Mayo scissors. “Your guy is over there.”

  On a gurney against the wall, a white sheet was draped over another hefty lump of body. Eli peeled back the sheet to reveal an older male. The breastplate had been replaced but the abdominal incision remained open.

  “Recognize him?”

  Eli hadn’t really looked at the face. “No, should I?”

  “Name’s Lankford,” Meg said. “Supposedly, he was a scientist at RBI.”

  “Bernie Lankford,” Eli said in a whisper.

  “What?”

  Eli stared at the man he was being hired to replace. “I thought he died on a trip, Caribbean somewhere.”

  Meg was weighing the heart and lungs. “St. Martin. There on business. Embryonic stem cell meeting.”

  He must have been in charge of the stem cell division, before Tsarina, Eli thought. “So how did he end up here?”

  “They didn’t want the body there. Got a call from a Dr. Francisco, ER physician. Said there was something odd about his death, like he suspected foul play. Begged me to take the body, so here he is.”

  “And?”

  Meg snapped off her gloves and faced Eli. “Like your friend Gaston. Aneurysm repaired with same kind of graft. Identical.”

  “An RBI endovascular graft?”

  “Yes. And the aorta was blown out around it.”

  Eli looked again at the body. “I have a feeling there’s more.”

  Meg went to the microscope. “Oh yeah.” She focused the scope and turned on the arrow. “Most of the cells are endothelial, as you might expect, ingrowth of vascular cells trying to coat the new lumen.” She rotated the knobs again for a more precise location. “Here they are.”

  Eli recognized the cells immediately. Their cuboidal shape, dense granules in the cytoplasm, and the way they rounded up when in contact with a neighboring cell. The same cells he had worked two years to produce and had brought with him to Memphis. He looked at Meg as if she had the answer. “How did those cells get there?”

  “I was hoping you could tell me,” she said, back at the microscope again. After locating the spot, she motioned for him. “There’s a third population of cells this time.”

  Intermixed with the MMP cells were smaller, bizarre-looking cells. They weren’t endothelial cells from the native aorta, but the same dense, packed granules were present.

  “What are they?” Eli asked.

  “You’re not going to believe me.”

  Eli looked up from the microscope.

  “They’re embryonic stem cells.”

  He examined the cells again as though he might recognize them with another look.

  “I stained them for embryonic markers. They’re all positive.”

  “But how? How could they get here?”

  “The same way the MMP cells got here, I guess.”

  “And how’s that?” Eli asked.

  Meg walked over to the white board above her desk and removed a blue marker.

  “First we had your friend.” She wrote the name Gaston. “We found MMP-producing cells in his ruptured aorta.” She drew an arrow down and wrote MMP cells. “Now this fellow.” She put Lankford’s name at the top of the board, parallel to Gaston. “Death from the same cause, ruptured aorta.” She drew a line down to MMP. “Same cells but now mixed in with embryonic stem cells.” She wrote ESC as an abbreviation.

  “Bizarre,” Eli said.

  “Dr. Francisco gave me some more information. At the time, it didn’t make sense.”

  “What?”

  Meg removed a piece of paper from her desk. “Lankford’s wife said that her husband had his graft checked the morning he died.”

  “Checked?”

  “Some kind of interventional radiology procedure, under fluoroscopy.”

  Eli thought about the natural history of endovascular grafts. A significant number required a catheter-based intervention to correct an abnormal placement or migration.

  Meg continued. “Mrs. Lankford said the procedure was done by the same surgeon that placed his aortic graft, a Dr. . . .” She hesitated as she searched her notes for the name. “Korinsky.”

  Eli shot her a look.

  “You know him?” Meg asked.

  “Yeah, I know him.” Eli looked at the diagram on the board. “You think these cells could have been introduced during Korinsky’s procedure?”

  Meg hunched her shoulders, pulling her scrub shirt tight against her chest. “You got a better idea?”

  Eli looked again through the microscope. “The endothelial cells, are they endogenous or exogenous?

  “What do you mean?”

  “The cells don’t look incorporated like normal ingrowth cells. They’re scattered in patches.”

  Meg bumped Eli out of the way with her hip. “Okay, I’ll give it to you—patches.” She faced Eli again. “What would be the purpose of injecting endothelial cells?”

  “To speed up the engrafting process.”

  Meg looked at him with both eyebrows raised.

  “Consider this,” Eli said. “There are hundreds and hundreds of people walking around with these aortic grafts. What if you were the manufacturer and all of a sudden they started to blow?”

  “You’d do anything to stop it.”

  Meg went back to the board and drew a straight line between Gaston’s name and Lankford’s. She put a question mark below the line. “There has to be a connection.”

  Eli stood in front of the board and studied the diagram. He took the marker from Meg and wrote, on top of the line in capital letters: RBI.

  Korinsky had just returned to his office when his secretary informed him, “A Mr. Harvey Stone called. Said it was urgent.”

  He took the sticky note with the phone number on it and sat at his desk. He had finished a busy day in the Gates Memorial Endovascular Clinic and needed to dictate his procedure notes. Each of the clinic patients had had an AortaFix graft placed within the past three months. Two of the company’s devices had already failed, both with fatal results. For Korinsky, there was plenty of incentive to protect RBI’s AortaFix device. The money that he was paid for using it in his patients made his academic salary seem like servant’s pay. Frantically, Korinsky was trying to salvage the grafts that might be in jeopardy.

  He performed the procedures under X-ray guidance, snaking the catheter through an artery in the left groin and up to the site of the aortic vascular graft. When the tip lay within the AortaFix device, Korinksy injected endothelial cells through the catheter, the same cells that form the natural lining of the human aorta. But these cells had been engineered at RBI, by Tsarina, to attach to the device, thereby sealing it in place to prevent graft migration and device failure. If it worked, the procedure would be the latest advance in endoluminal therapy, making Korinsky the top endovascular surgeon in the country. And when RBI obtained the patent and marketed the technique, the financial windfall would be staggering.

  He stared at the note, fully aware that a call from Stone was more pressing than any medical dictation. Korinsky dialed the number, connecting after the first ring.

  “I said to rock his world a bit, not kill his lab tech.”

  “Afternoon to you too, Harvey. Now, what the hell are you talking about?”

  “Don’t play dumb with me, Korinsky. That was a stupid move. We don’t need the police on our ass.”

  “Either you tell me or I’m hanging up.”

  “At Branch
’s lab this morning.” Stone hesitated. “The woman—murdered.”

  Korinsky remained silent. From the endovascular clinic, he had heard the sirens earlier that morning, had seen police cars outside Medical Center North, but he hadn’t known it was a crime scene.

  Stone was catching onto this fact. “You had nothing to do with it?”

  “No, I swear.”

  “Who else is after Branch then?”

  Korinsky thought a moment. “I don’t know, but this could be good for us. Another reason for our nosy surgeon to leave the medical center and quit snooping around the autopsy room.”

  CHAPTER TWENTY-FIVE

  OFFICE OF DR. KARL FISHER

  4:45 P.M.

  Eli sat in a straight-backed chair and faced his chairman for the second time in three days. Fisher wasted no time.

  “I’ve been chairman for over a decade.”

  Eli could feel the lecture coming.

  “I have built the careers of more young surgeons than I care to remember. You were selected to be the next, Branch. Remember, I am the one who determines your future.”

  He gave that familiar hesitation, a father disappointed in his son.

  “It’s really not too hard. You show up, do some cases, take care of patients, and publish some research.”

  Fisher said this as if he was the manager of a fast-food joint instructing a new hire on how to slap a burger together.

  “I run a department of over two hundred employees. All of them want more space, more time, more money.”

  He hesitated before the punch line.

  “And you’re more of a pain in the ass than all of them put together.”

  Eli had to admit, it was a very effective line.

  “Why is that, Branch? Can you tell me why that is?”

  He thought a moment but had no explanation. The case with Korinsky, Vera’s death in his lab. A few weeks ago he was the hot new recruit. Now he was the subject of a criminal investigation and the lead story on the local news.

  “I don’t really know.”