OCTOBER 17, 2007
WEDNESDAY, 10:11 P.M.
NEW DELHI, INDIA
Ramesh Srivastava did all he could to keep his composure. Here it was after ten at night and he was getting yet another call. To him it has seemed like he’d been on the phone all evening. First it had been his deputy of the department of medical tourism calling to say that his immediate subordinate deputy had called him only minutes earlier with the disappointing news that there’d been a report on CNN of yet another American patient death in a private Indian hospital. It was the third in three days, this time at the Aesculapian Medical Center. What made it particularly newsworthy was that the patient, David Lucas, was only in his forties. No sooner had Ramesh finished that unsettling call than he got a call from Khajan Chawdhry, the CEO of the involved hospital, with all the details as he knew them. Now here was the phone ringing yet again.
“What is it?” Ramesh demanded, with no attempt at sociability. As a high-ranking Indian civil servant, he didn’t expect to be working this hard.
“It is Khajan Chawdhry again, sir,” the CEO said. “I’m sorry to bother you, but a slight problem has developed in relation to one of your specific orders—namely, your insistence there should be no autopsy.”
“How can there be a problem?” Ramesh demanded. “It’s a very simple order.”
Earlier, Khajan had explained the bizarre sequence of events involving David Lucas’s demise, starting with the incipient cyanosis with no airway obstruction, followed by the changes in the heart’s conduction system and a sudden rise in the patient’s temperature and potassium level. As a nonphysician, Ramesh had asked for a translation of the irritating doctor gobbledygook and had been told the man had died of some sort of heart attack/stroke combination as a best-guess hypothesis. Ramesh’s response had been for the attending surgeon to sign the death certificate as exactly that, and under no circumstances ask for an autopsy to be authorized.
“The problem is the wife,” Khajan said sheepishly. “She said she may want an autopsy.”
“People generally do not want autopsies,” Ramesh said irritably. “Did the surgeon talk her into requesting one after I specifically ordered him not to do so?”
“No, the surgeon is well aware of the general negative feeling about autopsies in the private sector, and specifically aware of your feelings in this case. It wasn’t he who has spoken to the wife about an autopsy, but rather another American, by the name of Jennifer Hernandez, who had called her prior to the wife’s even hearing about her husband’s death. It was this Hernandez woman who raised the issue of a possible autopsy by saying several American forensic pathologists were on their way to look at her grandmother, and could look at her husband as well, provided the husband’s body was not cremated or embalmed.”
“Not her again!” Ramesh groaned out loud. “This Hernandez woman is becoming intolerable.”
“What should I do if Mrs. Lucas insists on the autopsy?”
“Like I told Rajish Bhurgava over at the Queen Victoria, make sure the autopsy request gets picked up by one of the magistrates we’re accustomed to working with, and inform him there’s to be no autopsy. Meanwhile, try your best to get Mrs. Lucas to agree to cremate or embalm. Lean on her! Is she still at the hospital?”
“She is, sir.”
“Do your best.”
“Yes, sir.”
Ramesh disconnected and immediately called Inspector Naresh Prasad.
“Good evening, sir,” Naresh said. “I don’t hear from you for months, then twice in one day. What can I do for you?”
“What have you learned?”
“What have I learned about what?”
“About the mole in the Queen Victoria Hospital and the thorn in my side, Jennifer Hernandez.”
“You’re joking. We just spoke today. I haven’t started looking into either issue yet. I’m just putting a team together for tomorrow.”
“Well, both problems are getting worse, and I want some action.”
“How are they getting worse?”
“There was another death, and again CNN had it on the air almost immediately. I heard about it from a deputy whose assistant happened to catch it on TV not much later than the CEO of the hospital heard it directly from his staff doctor who’d tried to resuscitate the patient.”
“Am I to assume it was the same hospital, the Queen Victoria?”
“No, this time it was the Aesculapian Med Center.”
“Interesting! Changing hospitals might help if the culprit is a staff physician. He or she would have to have privileges at both hospitals. That could narrow the list down quite nicely.”
“Good thought. That hadn’t occurred to me.”
“Maybe that’s why you’re a bureaucrat and I’m a police investigator. What about the woman? What’s she done to irritate you further?”
Ramesh told Naresh what Khajan had told him about Jennifer talking the wife into requesting an autopsy even before the hospital had informed the woman her husband had died.
“How did the Hernandez woman know the man had died?”
“I don’t know for certain, but I’d have to guess she saw it on CNN International.”
“Maybe she knows someone at CNN who is informing her. What do you think of that idea?”
For a moment Ramesh did not respond. He found himself getting vexed at wasting his time with such mental gymnastics. That was Naresh’s job, not his. What he wanted was results. He wanted to be rid of the whole mess so that the public-relations damage could be fully accessed and then, he hoped, repaired.
“Listen!” Ramesh said suddenly, ignoring Naresh’s question. “What it all comes down to is this. Jennifer Hernandez is making a supreme nuisance of herself, and in the process putting the future of Indian medical tourism in jeopardy, particularly from the perspective of the United States, which promises to be our biggest potential market because of its idiotic healthcare system and the out-of-control medical inflation it fosters. I want you to take care of this woman, either yourself or some agent you trust. Tail her for a couple of days and keep me informed in real time who she sees, who she talks with, and where she goes. I want a full report, and most of all I want a reason to deport her without causing a scene or publicity of any sort. If she’s not doing anything wrong, conjure it up. But for heaven’s sake don’t make a martyr of her, meaning no strong-arm tactics. Understood?”
“Quite so,” Naresh said. “I will start in the morning with the Hernandez woman, and I will see to it myself. I will also put a trusted agent on the issue of who is tipping off CNN.”
“Perfect,” Ramesh said. “And as I said, keep me informed.”
As he hung up the phone, Ramesh noisily exhaled in exasperation. Although he felt good about having built a little fire under Naresh and took the man at his word, meaning he expected him to follow Jennifer Hernandez around starting in the morning, the question of whether it would be enough and soon enough dogged him. In his mind he considered Naresh dependable and reasonably competent but certainly not the sharpest knife in the cutlery drawer. At the same time, Ramesh worried what the effect of yet another death reported by CNN was going to have on the higher-ups who’d called him that very afternoon to complain about the other two. It was clear it wasn’t going to be positive, and it cast more doubt on the efficacy of Naresh’s methodical but slow style. Such thinking reminded Ramesh of his call that afternoon to Shashank Malhotra, who was anything but slow and methodical. Believing it couldn’t hurt to rile the rash businessman a little more, Ramesh picked the phone back up and made what he hoped would be the last call of the day.
“Are you calling me with some good news this time?” Shashank demanded as soon as he knew who was calling.
“I wish that were the case,” Ramesh responded. “Unfortunately, there was another medical tourist death tonight that has already been reported on CNN International.”
“Was it again at Queen Victoria?” Shashank demanded. It was clear he was in no mood for small talk.
“That’s the single aspect of the event on the positive side,” Ramesh said. “It was at the Aesculapian Med Center on this occasion.” In a way, Ramesh was provoking Shashank with this comment, knowing the Aesculapian Med Centers were just as much a part of Shashank’s holdings as the Queen Victoria Hospital. “The bad aspect is that the patient was young and leaves behind a wife and two children. Such a story frequently garners more media
